May 29, 2017
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Zolpidem

Medical and Pharmacy Editor:

Brand Name: Ambien, Ambien CR, Edluar, Intermezzo, Zolpimist

Generic Name: zolpidem

Drug Class: Sedative/Hypnotics

What Is Zolpidem and How Does It Work?

Zolpidem is used to treat sleep problems (insomnia) in adults. It helps you fall asleep faster and stay asleep longer, so you can get a better night's sleep. It may also reduce the number of times you wake up during the night. Zolpidem belongs to a class of drugs called sedative-hypnotics. It acts on your brain to produce a calming effect.

Zolpidem is available under the following different brand names: Ambien, Ambien CR, Edluar, Intermezzo, and Zolpimist.

Dosages of Zolpidem:

Adult Dosage Forms and Strengths

Tablet, immediate-release: Schedule IV

  • 5 mg (Ambien)
  • 10 mg (Ambien)

Tablet, extended-release: Schedule IV

  • 6.25 mg (Ambien CR)
  • 12.5 mg (Ambien CR)

Tablet, sublingual: Schedule IV

  • 1.75 mg (Intermezzo)
  • 3.5 mg (Intermezzo)
  • 5 mg (Edluar)
  • 10 mg (Edluar)

Oral spray: Schedule IV

  • 5 mg/spray (Zolpimist)

Dosage Considerations – Should be Given as Follows:

Not recommended for pediatric use.

Insomnia

Sleep initiation

Immediate-release tablet, sublingual tablet, and oral spray

  • Dosing for orally (Ambien), sublingually (SL) (Edluar), and oral spray (Zolpimist)
  • Women: 5 mg orally/sublingual/oral spray at bedtime
  • Men: Consider 5 mg orally/sublingual/oral spray at bedtime; may use 10 mg orally/sublingual/oral spray at bedtime if needed

Extended-release (Ambien CR)

  • Women: 6.25 mg orally at bedtime
  • : Consider 6.25 mg orally at bedtime; may use 12.5 mg orally at bedtime; not to exceed 12.5 mg/day

Dosing considerations (Ambien, Ambien CR)

  • lowest effective dose; take only once per night immediately before bedtime with at least 7-8 hours remaining before the planned time of awakening
  • In some patients, higher morning blood levels following use of 10 mg dose increase the risk of next day impairment of driving and other activities that require full alertness
  • Total dose should not exceed 10 mg once daily immediately before bedtime; should be taken as single dose and should not be re-administered during same night

Geriatric dosing

Immediate-release, oral spray: 5 mg orally/sublingually immediately before bedtime

Extended-release: 6.25 mg orally immediately before bedtime

Insomnia (Intermezzo)

Insomnia when a middle of the night awakening is followed by difficulty returning to sleep

Women: 1.75 mg sublingually (SL) as needed; not to exceed 1 dose/night

Men: 3.5 mg SL as needed; not to exceed 1 dose/night

Geriatric: Men and women: 1.75 mg sublingually as needed; not to exceed 1 dose/night

Dosing considerations (Intermezzo)

  • Use only when 4 hours or more of bedtime remain before awakening
  • Do not take if alcohol has been consumed or with any other sleep aid
  • Concomitant with CNS depressants: 1.75 mg SL as needed; not to exceed 1 dose/night

Dosing Modifications

Renal impairment

  • Dose adjustment may not be necessary; monitor

Hepatic impairment

  • Immediate-release: 5 mg immediately before bedtime
  • Extended-release: 6.25 mg immediately before bedtime
  • Sublingual (Edluar): 5 mg immediately before bedtime
  • Sublingual (Intermezzo): 1.75 mg once at night if 4 hours or more remain before awakening

Geriatric dosing considerations

Drug of choice when hypnotic indicated in elderly

Ambien, Ambien CR: Use lowest effective dose; take only once per night immediately before bedtime with at least 7-8 hours remaining before the planned time of awakening

Intermezzo: Use only when 4 hours or more of bedtime remain before awakening; do not take if alcohol has been consumed or with any other sleep aid

Medically Reviewed by a Doctor on 4/10/2017



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